ELEANOR V BAUTISTA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

First Name

ELEANOR V

Last Name

BAUTISTA

Business Name

ELEANOR V BAUTISTA

Original Issue Date

06/02/2008

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

JOLIET

State

Zip

60435

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023